CARDIOVASCULAR SYSTEM

By Dr. Shamanthakamani Narendran

INTERNAL VIEW OF THE HEART

Chambers: The heart is divided by a septum into two halves. The halves are in turn divided into chambers. The upper two chambers of the heart are called atria and the lower two chambers are called ventricles. Valves allow blood to flow in one direction between the chambers of the heart.

INTERIOR STRUCTURES OF THE HEART

ELECTROCARDIOGRAM

Pathological conditions
Arrhythmia / Dysrhythmia Heart block / Atrio ventricular block: Failure of conduction of impulses through the A.V.Node. Damage to the S.A.Node causes week impulses failing to reach the ventricles. Cardiac pacemaker establishes normal rhythm. It is a small, battery-operated electronic device. It is inserted under the skin. It has leads that travel through a large vein to the heart, where the wires are anchored, which send the electrical impulses to the heart.

Flutter: Rapid, regular contraction of atria or ventricle reaching upto 250/300 beats per minute. Fibrillation: Rapid, random, irregular contraction reaching upto 350-400 beats per minute. Defibrillator is applied to the chest wall to help in cardioversion. Defibrillation is a technique used to counter the onset of ventricular fibrillation, a common cause of cardiac arrest. Defibrillation is part of an advanced cardiac life support. It applies a controlled electric shock.

Defibrillator

Cardiac Arrest: Sudden stoppage of heart. Palpitation: Uncomfortable sensation in the chest associated with arrhythmia. This causes 1. Premature atrial contraction (PAC) 2. Premature ventricular contraction (PVC).

Myocardial Infarction / Heart Attack

Angina Pectoris
Hardening of the arteries, and the presence of a thrombus, or clot, in a blood vessel are the most common causes of obstruction. Arteriosclerosis is responsible for most of the deaths resulting from heart attacks. Spasms of the coronary arteries can also result in a heart attack.

Cardiac Catheterization

It is used to study the various functions of the heart. The coronary arteries can be viewed by injecting dye. The oxygen concentration can be measured across the valves and walls of the heart and pressures within each chamber

Radio frequency catheter ablation (RFA): Non surgical treatment to treat Arrhythmia. A catheter is placed in the blood vessel leading of the heart vessel, which delivers a high frequency current to burn a small portion of the muscle. This injury corrects heart block / arrhythmia.

Angiography

Percutaneous transluminal coronary angioplasty (PTCA)

Balloon angioplasty

Coronary artery bypass graph (CABG)

ATHERECTOMY

Rotational Athrectomy

Directional Coronary Athrectomy

Extraction Athrectomy

Electrocardiography (EKG / ECG)

Detects heart abnormalities, disease and damage by measuring the heart's rhythms and electrical impulses.

Echocardiography
The image shows the motion pattern and structure of the four heart valves, revealing any potential leakage (regurgitation) or narrowing (stenosis). During this test, a Doppler ultrasound may be done to evaluate cardiac blood flow.

Stress Test/ Exercise tolerance test (ETT) / treadmill test

It can assess the hearts reaction under physical stress.

During an exercise ST, an EKG is performed while the patient exercises in a controlled manner on a treadmill or stationary bicycle at varied speeds and elevations. During a pharmacological ST, a medication (e.g., dobutamine) is given to the patient, which causes the heart to react as if it were under the physical stress of exercise, though he is actually at rest.

Treatment for hyperlipidemia is diet and exercise. Drug therapy includes HMG reductors inhibitors which lower cholesterol also called "stains," eg, simbastain, lovastain, pravastain.

Tests
Digital subtraction angiography (DSA) Doppler ultrasound Echocardiography (ECHO) Nuclear cardiology: Positron emission tomography scan) Thallium 201 scintigraphy Technetium 99 ventriculography Magnetic resonance imaging (MRI)

(PET

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